Doctors are expected to uphold the sanctity of life and to do no harm on their patients. In my training in general medicine and internal medicine, our patients would usually come to us with a problem and we were expected to work our magic on them and eliminate the disease thereby making them well. In the course of our studying to become doctors and our training to become specialists, we developed this notion that we have failed whenever we couldn’t improve our patients, when we could not eliminate the disease and most especially, when our patients die. It has become a significant part of our identities to cure and to save lives.
“I am here to cure you and banish your cancer from your body forever and vow to make it never ever come back until the end of time. I will use all my force, my knowledge and my time to make sure that no patient ever dies from this dreaded disease. Cancer patients here I come to save you”.
This was my mindset when I started training in oncology. Nowhere did I know that I was bound for major disappointment even bordering on depression and quitting.
When a patient who is previously healthy gets stricken with an ordinary to moderate illness, their natural course is to recover over time when given appropriate treatment. A regular patient who is wheelchair or bed-bound is expected to leave the hospital walking and with more gusto after treatment. However, such is not always the case for patients with cancer or severe illnesses. They follow a different pattern. These patients often do not have time on their side. The natural course of their disease is often towards dissemination to other parts of the body or sometimes recovery but not towards their baseline or better. They sometimes recover a little bit but perhaps not enough to get back to baseline. The timeline though for these patients can vary from days, weeks, months, years or sometimes even decades. A substantial number can even follow a very short-lived course.
“I did not sign up for this!!!!!” I said to myself. “No! I was promised that I will save them. Probably, it’s just because the patient was already weak when he came to me. The next patient will be ok. I will make sure of that”.
The next patient came and I did it. Cancer gone. Patient has been in remission for a very long time now. Success!!!! See, I told you.
Then another patient came, not as good as the second one. “I can do it! I can do it!”.
Then another one came and another one and another one and another one. When I started counting, it seemed like a significant number did not turn out well. I said no!!! This cannot be!!!! I need to study some more and more and more. Give more medicines and more and more and more. This cannot be happening to me!! No! No! No!
It was exhausting. I thought that I would get a reprieve from my toxic duties by going into oncology training. But the situation is proving to be different. I am not sure if I want this. Get me out of here!!!!!!!!